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Antela A, Rivero A, Llibre JM, Moreno S. Redefining therapeutic success in HIV patients: an expert view. J Antimicrob Chemother 2021; 76:2501-2518. [PMID: 34077524 PMCID: PMC8446931 DOI: 10.1093/jac/dkab168] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Thanks to advances in the field over the years, HIV/AIDS has now become a manageable chronic condition. Nevertheless, a new set of HIV-associated complications has emerged, related in part to the accelerated ageing observed in people living with HIV/AIDS, the cumulative toxicities from exposure to antiretroviral drugs over decades and emerging comorbidities. As a result, HIV/AIDS can still have a negative impact on patients' quality of life (QoL). In this scenario, it is reasonable to believe that the concept of therapeutic success, traditionally associated with CD4 cell count restoration and HIV RNA plasma viral load suppression and the absence of drug resistances, needs to be redefined to include other factors that reach beyond antiretroviral efficacy. With this in mind, a group of experts initiated and coordinated the RET Project, and this group, using the available evidence and their clinical experience in the field, has proposed new criteria to redefine treatment success in HIV, arranged into five main concepts: rapid initiation, efficacy, simplicity, safety, and QoL. An extensive review of the literature was performed for each category, and results were discussed by a total of 32 clinicians with experience in HIV/AIDS (4 coordinators + 28 additional experts). This article summarizes the conclusions of these experts and presents the most updated overview on the five topics, along with a discussion of the experts' main concerns, conclusions and/or recommendations on the most controversial issues.
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Affiliation(s)
- Antonio Antela
- Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Antonio Rivero
- Hospital Universitario Reina Sofía, Cordoba, Spain
- Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain
| | - Josep M Llibre
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Santiago Moreno
- Hospital Universitario Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, Spain
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Leong R, Owusu L, Tang J, John N, Voyer KE, Gargala E, Daigler B, Ma Q, Morse GD, Cha R. Patient-reported outcomes for HIV: the future of long-acting injectables and antiretroviral therapy evaluations. Future Virol 2021. [DOI: 10.2217/fvl-2020-0322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Patient-reported outcomes (PROs) are an increasingly important aspect of patient care, as they offer a perspective from the patient themselves in the treatment and management of a particular disease state. They have a potential role in helping clinicians select an appropriate drug regimen in human immunodeficiency virus-1 (HIV-1)-infected individuals, as well as those with HIV/hepatitis C (HCV) co-infection. They can also provide insight for individuals receiving long-acting (LA) injectable antiretroviral therapy (ART). Studies found from PROs that participants on an LA injectable ART regimen reported greater preference and treatment satisfaction compared with those on an oral ART regimen. Some additional studies have also used PROs to evaluate the switch to single-tablet regimens and compare different ART in treating HIV-1. Current PROs and how they can be improved for LA injectables were also discussed.
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Affiliation(s)
- Richard Leong
- Department of Pharmacy, University at Buffalo, School of Pharmacy & Pharmaceutical Sciences, Buffalo, NY 14214, USA
| | - Leon Owusu
- Department of Pharmacy, University at Buffalo, School of Pharmacy & Pharmaceutical Sciences, Buffalo, NY 14214, USA
| | - Jerrica Tang
- Department of Pharmacy, University at Buffalo, School of Pharmacy & Pharmaceutical Sciences, Buffalo, NY 14214, USA
| | - Neeraj John
- Department of Pharmacy, University at Buffalo, School of Pharmacy & Pharmaceutical Sciences, Buffalo, NY 14214, USA
| | - Kira E Voyer
- Department of Pharmacy, University at Buffalo, School of Pharmacy & Pharmaceutical Sciences, Buffalo, NY 14214, USA
| | - Emma Gargala
- Department of Pharmacy, Catholic Health System, Buffalo, NY 14214, USA
| | - Benjamin Daigler
- Department of Pharmacy, Catholic Health System, Buffalo, NY 14214, USA
| | - Qing Ma
- Department of Pharmacy, University at Buffalo, School of Pharmacy & Pharmaceutical Sciences, Buffalo, NY 14214, USA
- Department of Pharmacy, Center for Integrated Global Biomedical Sciences, Buffalo, NY 14214, USA
| | - Gene D Morse
- Department of Pharmacy, University at Buffalo, School of Pharmacy & Pharmaceutical Sciences, Buffalo, NY 14214, USA
- Department of Pharmacy, Center for Integrated Global Biomedical Sciences, Buffalo, NY 14214, USA
| | - Raymond Cha
- Department of Pharmacy, University at Buffalo, School of Pharmacy & Pharmaceutical Sciences, Buffalo, NY 14214, USA
- Department of Pharmacy, Center for Integrated Global Biomedical Sciences, Buffalo, NY 14214, USA
- Department of Pharmacy, Catholic Health System, Buffalo, NY 14214, USA
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